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Cheder Menachem Mount Pleasant

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Child's Information

Last name*

First name*

Nickname*

Age*

Bar Mitzvah Date*

What grade is your child entering?

Grade 8th

Grade 9th

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Please describe any concerns or issues regarding the child:*

Father's Information

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Father's Email*

Street Name*

City*

State*

Postal Code*

Country*

Mother's Information

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Mother's Phone*

Mother's Email*

Other Information

Please tell us why you are really excited for your son to have this opportunity, how he can benefit, and how he can contribute:

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Cheder Menachem Mount Pleasant

office@chedermenachemmp.org | 201-250-5385 | chedermenachemmp.org

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